Orthopedics-Online

Pressure disc prosthesis

The topic of the pressure disc prosthesis is now viewed very critically. In particular, the early occurrence of loosening has made the pressure disc prosthesis numerically niche.
The future will tell whether the pressure disc prosthesis will disappear from the market or innovations will help it achieve a renaissance.

Synonyms

artificial hip joint
Total hip replacement (HTEP or HTE)
Hip joint prosthesis
Total hip replacement
HEP, TEP, HTEP
Hip replacement

English: hip prosthesis

definition

The word "artificial hip joint " is to be equated with the designation “total hip joint endoprosthesis”.
In the context of a hip prosthesis implantation operation, the human hip joint replaced by an artificial one, which in principle consists of the same parts. This means: In the course of such an operation you replace the joint socket, the Femoral neck and the femoral head.

In the Pressure disc prosthesis the "prosthesis socket" is anchored in a special way.

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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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An alternative prosthesis model is the pressure disc prosthesis

Pressure disc prosthesis

Even if this form of prosthesis anchoring was developed in Switzerland around 20 years ago, it has only been on the market for several years. First, a pilot study on enlightened patients had to deliver test results.

Compared to the other (conventional) prosthesis models, this form of prosthesis anchoring offers some advantages, but also known disadvantages, which will be discussed below

In contrast to the cemented or non-cemented shaft-fixed prosthesis models, a significantly smaller part of the healthy bone has to be removed when implanting a pressure disc prosthesis, since only the femoral head itself has to be removed.
This procedure is comparable with that of the new prosthesis development of the short-stem prosthesis.
While the thigh is heavily loaded during the implantation of a hip prosthesis and, especially in the areas splinted by the prosthesis, the bones cannot be constantly reduced and built up as usual, a pressure disc prosthesis puts a strain on the bone throughout.This means that the elasticity of the bone is significantly less restricted and, as a rule, remains unaffected.
Loosening of the prosthesis after inflammation or due to other factors is the most common reason for a prosthesis replacement operation. Since the Loosening of the hip prosthesis does not occur in its entirety, the prostheses are usually still very firmly anchored in the bone, so that such a replacement operation places great demands on the surgeon. Very often, non-destructive removal of the old prosthesis is not possible due to the firm anchorage. As a rule, a so-called window is then sawn into the long bone. The consequence is a relatively long operation time, combined with a significantly increased risk of complications. A pressure disc change operation can be carried out with relatively little effort, either with a new pressure disc or a so-called normal hip prosthesis, if it is loosened.

The replacement operations listed under 3 are usually necessary after about 10 to 15 years. If an implantation takes place at an advanced age, the lifespan of such a prosthesis is not really relevant.

However, if a younger patient needs a prosthesis, the likelihood is that one is necessary Change operation clearly increased. For a thirty-year-old patient, this can mean two or possibly three alternate operations. However, since the anchoring options decrease with every change operation, the pressure disc prosthesis can initially serve as an alternative. If such a prosthesis is initially implanted, it remains Bone substance as an anchoring option for conventional hip prosthesis models and thus the quality of the subsequent replacement operations also increases.

durability

However, the pressure disc prosthesis shows - and this should be noted critically at this point - in comparison to the classic prosthesis models, a loosening rate that occurs much earlier in some cases.
Through this increased loosening rate if the replacement operation is necessary prematurely, this prosthesis model is again used significantly less frequently than it was in the 1990s.
As already mentioned, this type of prosthesis is therefore recommended for young patients who want to postpone the implantation of a conventional model with this type of prosthesis.